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Article: Results of the Kirschner operation

TitleResults of the Kirschner operation
Authors
Issue Date1981
PublisherSpringer New York LLC. The Journal's web site is located at http://link.springer.de/link/service/journals/00268/
Citation
World Journal Of Surgery, 1981, v. 5 n. 4, p. 547-552 How to Cite?
AbstractBetween 1964 and 1979, a total of 1,536 patients with carcinoma of the thoracic esophagus were treated at the authors' center. Of these, 142 patients with unresectable tumor underwent the Kirschner operation for palliation. In this operation, esophageal obstruction is bypassed by subcutaneous or retrosternal gastric esophagoplasty, and the thoracic esophagus defunctionalized by a long Roux-en-Y jejunal loop to the abdominal esophagus. Dysphagia is thus relieved and aspiration of esophageal and gastric contents into the respiratory tract avoided. Any patient who was not discharged from the hospital for any reason and eventually died in the hospital is counted as a mortality. The hospital mortality for these 142 patients was 41.5% (59 patients). In recent years there has been a reduction in mortality rate. The most common cause of death was progressive bronchopneumonia (72.9%). Leakage of anastomosis occurred in 67 patients (47.2%), but most healed on conservative treatment. The ability to eat normally was restored in 69% of survivors, and another 28% were able to tolerate a soft diet. Although temporary postoperative aspiration was occasionally encountered when the patient started oral feeding, once swallowing was established, tracheobronchial aspiration did not occur. The mean survival of the discharged patients was 5.0 months. Malignant cachexia from growth of the primary tumor accounted for 61.4% of late deaths; metastatic disease, 10.8%; and cardiopulmonary insufficiency, the remainder. One patient is alive more than 5 years after operation, and presumably was cured by postoperative radiotherapy. Although the mortality rate of the Kirschner operation is substantial, other forms of treatment also have significant mortality rates but with less palliative potential. Therefore, we would recommend this operation for the palliation of unresectable carcinoma of the esophagus.
Persistent Identifierhttp://hdl.handle.net/10722/172514
ISSN
2015 Impact Factor: 2.523
2015 SCImago Journal Rankings: 1.375

 

DC FieldValueLanguage
dc.contributor.authorWong, Jen_HK
dc.contributor.authorLam, KHen_HK
dc.contributor.authorWei, WIen_HK
dc.contributor.authorOng, GBen_HK
dc.date.accessioned2012-10-30T06:23:11Z-
dc.date.available2012-10-30T06:23:11Z-
dc.date.issued1981en_HK
dc.identifier.citationWorld Journal Of Surgery, 1981, v. 5 n. 4, p. 547-552en_HK
dc.identifier.issn0364-2313en_HK
dc.identifier.urihttp://hdl.handle.net/10722/172514-
dc.description.abstractBetween 1964 and 1979, a total of 1,536 patients with carcinoma of the thoracic esophagus were treated at the authors' center. Of these, 142 patients with unresectable tumor underwent the Kirschner operation for palliation. In this operation, esophageal obstruction is bypassed by subcutaneous or retrosternal gastric esophagoplasty, and the thoracic esophagus defunctionalized by a long Roux-en-Y jejunal loop to the abdominal esophagus. Dysphagia is thus relieved and aspiration of esophageal and gastric contents into the respiratory tract avoided. Any patient who was not discharged from the hospital for any reason and eventually died in the hospital is counted as a mortality. The hospital mortality for these 142 patients was 41.5% (59 patients). In recent years there has been a reduction in mortality rate. The most common cause of death was progressive bronchopneumonia (72.9%). Leakage of anastomosis occurred in 67 patients (47.2%), but most healed on conservative treatment. The ability to eat normally was restored in 69% of survivors, and another 28% were able to tolerate a soft diet. Although temporary postoperative aspiration was occasionally encountered when the patient started oral feeding, once swallowing was established, tracheobronchial aspiration did not occur. The mean survival of the discharged patients was 5.0 months. Malignant cachexia from growth of the primary tumor accounted for 61.4% of late deaths; metastatic disease, 10.8%; and cardiopulmonary insufficiency, the remainder. One patient is alive more than 5 years after operation, and presumably was cured by postoperative radiotherapy. Although the mortality rate of the Kirschner operation is substantial, other forms of treatment also have significant mortality rates but with less palliative potential. Therefore, we would recommend this operation for the palliation of unresectable carcinoma of the esophagus.en_HK
dc.languageengen_US
dc.publisherSpringer New York LLC. The Journal's web site is located at http://link.springer.de/link/service/journals/00268/en_HK
dc.relation.ispartofWorld Journal of Surgeryen_HK
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshCarcinoma, Squamous Cell - Surgeryen_US
dc.subject.meshCardia - Surgeryen_US
dc.subject.meshEsophageal Neoplasms - Surgeryen_US
dc.subject.meshEsophagoplasty - Methodsen_US
dc.subject.meshFemaleen_US
dc.subject.meshFollow-Up Studiesen_US
dc.subject.meshHumansen_US
dc.subject.meshJejunum - Transplantationen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshPalliative Careen_US
dc.subject.meshPostoperative Complications - Epidemiology - Mortalityen_US
dc.subject.meshTime Factorsen_US
dc.titleResults of the Kirschner operationen_HK
dc.typeArticleen_HK
dc.identifier.emailWong, J: jwong@hkucc.hku.hken_HK
dc.identifier.emailWei, WI: hrmswwi@hku.hken_HK
dc.identifier.authorityWong, J=rp00322en_HK
dc.identifier.authorityWei, WI=rp00323en_HK
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.pmid6172906-
dc.identifier.scopuseid_2-s2.0-0019846290en_HK
dc.identifier.volume5en_HK
dc.identifier.issue4en_HK
dc.identifier.spage547en_HK
dc.identifier.epage552en_HK
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridWong, J=8049324500en_HK
dc.identifier.scopusauthoridLam, KH=7403657342en_HK
dc.identifier.scopusauthoridWei, WI=7403321552en_HK
dc.identifier.scopusauthoridOng, GB=7103137311en_HK

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